Provider Demographics
NPI:1154422004
Name:CHANG, JAMES Y (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:Y
Last Name:CHANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7879 ROSEDALE HWY
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5785
Mailing Address - Country:US
Mailing Address - Phone:661-316-8888
Mailing Address - Fax:661-282-8188
Practice Address - Street 1:7879 ROSEDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5785
Practice Address - Country:US
Practice Address - Phone:661-316-8888
Practice Address - Fax:661-282-8188
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40873207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A408730Medicaid
CAE72044Medicare UPIN
CA00A408730Medicare ID - Type Unspecified